EP4142667A1 - Dispositif de chirurgie vitréo-rétinienne - Google Patents

Dispositif de chirurgie vitréo-rétinienne

Info

Publication number
EP4142667A1
EP4142667A1 EP21725591.8A EP21725591A EP4142667A1 EP 4142667 A1 EP4142667 A1 EP 4142667A1 EP 21725591 A EP21725591 A EP 21725591A EP 4142667 A1 EP4142667 A1 EP 4142667A1
Authority
EP
European Patent Office
Prior art keywords
surgical instrument
cannula
receiving
needle
surgical
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP21725591.8A
Other languages
German (de)
English (en)
Inventor
Marco CODENOTTI
Lorenzo IULIANO
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP4142667A1 publication Critical patent/EP4142667A1/fr
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00727—Apparatus for retinal reattachment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00353—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping

Definitions

  • the present invention relates to a vitreoretinal surgery device.
  • the present invention finds particular application in the field of eye surgery, and more precisely, in the design and manufacture of surgical instruments adapted to be inserted into the eyeball to perform interventions aimed at the surgical treatment of diseases of the posterior part of the eye, in particular of the vitreous body and retina.
  • vitreoretinal surgery is based on the introduction of very thin instruments inside the eye, through some small incisions in the sclera, and on the maneuver thereof by the surgeon, who for obvious reasons can thus use a maximum of two instruments in the same operative moment.
  • the surgeon looks (with a microscope) inside the eye through the pupil, which is dilated with special eye drops, and while illuminating the operating area through a fiber optic torch held in one hand, performs the operations required by means of a special surgical instrument held in the other.
  • vitreoretinal surgery device which significantly reduces operating times and facilitates the instrument change for the surgeon.
  • a vitreoretinal surgery device comprising a main body, a needle or cannula, and a plurality of surgical instruments.
  • the main body (or handpiece) has an elongated shape extending along a longitudinal axis thereof between a first and a second end portion.
  • the main body is at least partially hollow inside and defines a receiving chamber therein.
  • the needle or cannula is connected to the main body and departs (or protrudes) away from the first end portion thereof up to a free end thereof.
  • the needle or cannula is also provided with an inner longitudinal cavity in connection with said receiving chamber and sized to receive at least one surgical instrument therein.
  • the device comprises at least a first surgical instrument of elongated shape, at least a second surgical instrument of elongated shape, and a selecting unit associated with said first and second surgical instruments, accommodated at least partially in said receiving chamber and configured to arrange the first surgical instrument in the operating position and the second surgical instrument in the resting position, and vice versa, upon a command given by a user. Therefore, the selecting unit is configured to move alternatively said first or said second surgical instrument from a resting position to an operating position upon a command given by a user.
  • the device is thereby a multi-instrument device in which there is only one needle or cannula which penetrates the sclera of the eye and in which two (or more) surgical instruments are slidably insertable.
  • Such surgical instruments can be for example a vitrectome, a laser endophotocoagulation probe, vitreous forceps (of any type), a back-flush cannula for the exchange of intraocular fluids or gases, endovitreal forceps, spatulas.
  • the first surgical instrument is provided with an active end portion thereof and is reversibly movable between a resting position, in which it is accommodated inside said receiving chamber, and an operating position, in which it is arranged crossing said inner longitudinal cavity with said active end portion protruding from the free end of the needle or cannula.
  • the second surgical instrument is also elongated in shape and has an active end portion thereof.
  • the second surgical instrument is also reversibly movable between a resting position, in which it is accommodated inside said receiving chamber, and an operating position, in which it is arranged crossing said inner longitudinal cavity with said active end portion protruding from the free end of the needle or cannula.
  • the other when one of the two instruments is extracted and placed through the needle, the other remains accommodated in the receiving chamber, thus favoring the maneuverability of the device and not hindering the operations by the surgeon.
  • the selecting unit is preferably configured alternatively to:
  • the selecting unit comprises a control element arranged at least partially outside said main body and operable by the user (surgeon, assistant surgeon, scrub nurse) to generate said first and said second.
  • the selecting unit comprises at least one thrust element associated with the first and second surgical instruments and movable parallel to said longitudinal axis between a retracted position and an extracted position, in which the first or second instrument is arranged in the operating position.
  • the thrust element is substantially aligned with a central axis of said needle or cannula.
  • the selecting unit preferably comprises at least one drum provided with at least a first seat for receiving said first surgical instrument and at least a second seat for receiving said second surgical instrument.
  • This drum is movable between at least a first position, in which the first receiving seat is aligned with said needle or cannula, and a second position, in which the second receiving seat is aligned with said needle or cannula. Therefore, the movement of the drum places the instrument required by the surgeon in alignment with the needle or cannula, while the thrust element translates it axially, positioning the active end portion thereof outside the needle or cannula (i.e., in the eye).
  • the drum in the operating position of the first surgical instrument, is preferably positioned so that the first receiving seat is aligned with the needle or cannula and the thrust element associated with the first surgical instrument is arranged in an extracted position, at least partially accommodated inside said first receiving seat.
  • the drum In the operating position of the second surgical instrument, the drum is positioned so that the second receiving seat is aligned with the needle or cannula and the thrust element associated with the second surgical instrument is arranged in an extracted position, at least partially accommodated inside said second receiving seat.
  • the user thus operates the control element by generating the first signal or the second signal.
  • the selecting unit positions the first or second surgical instrument in the operating position (and the second or first surgical instrument in the resting position), respectively.
  • the thrust member is maintained or brought into the retracted position, so that the surgical instrument possibly connected thereto returns to the respective receiving seat.
  • the drum moves (e.g., rotates) to bring the receiving seat of the selected surgical instrument at the needle or cannula, or in alignment with the needle or cannula.
  • the thrust member is then grafted (or comes into contact) with said surgical instrument so as to push it linearly through the needle or cannula up to the operating position.
  • the surgeon can thus send a driving signal to an actuation member of the first or second surgical instrument, actuating it and thus performing the related maneuver during the operation.
  • a driving unit e.g., pedal board
  • the driving signal is representative of the movement of the blade and the suction pressure of the vitreous body.
  • the driving signal provides the command to switch on the laser.
  • the driving signal (which can also be mechanical/analogue) is representative of the opening or closing of the arms.
  • FIG. 1 shows a vitreoretinal surgery device according to the present invention, during use
  • FIG. 2 diagrammatically shows a vitreoretinal surgery device according to the present invention, in a first embodiment
  • FIG. 3 shows a diagrammatic side view of a vitreoretinal surgery device according to the present invention, in a second embodiment and with some parts in phantom;
  • figure 4 shows a sectional view along section line IV-IV in figure 3;
  • FIG. 5 shows a perspective view of a vitreoretinal surgery device according to the present invention, in a third embodiment
  • FIG. 6 shows a diagrammatic side view of the vitreoretinal surgery device in figure 5;
  • FIG. 7-8 show portions of the vitreoretinal surgery device in figure 5;
  • FIG. 9-10 diagrammatically show a portion of the vitreoretinal surgery device in figure 5 in two different operating conditions
  • FIG 11 schematically shows the same portion of the vitreoretinal surgery device in figure 9 in a further operating condition
  • figure 12 shows the same portion of the device in figure 11 in perspective and with some parts in phantom.
  • reference numeral 1 indicates, as a whole, a vitreoretinal surgery device according to the present invention.
  • Such a device 1 thus belongs to the field of micro-invasive surgical instruments used to operate inside the eye.
  • the device 1 essentially comprises a main body 2, a needle or cannula 3 and a plurality of surgical instruments 3, 4, 5, 6.
  • the main body 2 has an elongated shape extending along a longitudinal axis “A” thereof between a first 2a and a second end portion.
  • the shape of the main body 2 is at least partially substantially cylindrical, possibly with a tapered end having dimensions such as to allow an easy grip by the surgeon or user “S”.
  • the main body 2 preferably has at least one grippable portion 2b having a substantially circular section, with a diameter of less than 5 cm.
  • the main body 2 is preferably at least partially hollow and defines a receiving chamber “C” therein.
  • the needle or cannula 3 instead has a tubular shape (i.e., hollow inside), with a diameter preferably less than 1 mm (approximately 19 gauge). Therefore, such a needle or cannula 3 has an inner longitudinal cavity extending parallel to the longitudinal axis “A”.
  • Such an inner longitudinal cavity is placed in connection with the receiving chamber “C”.
  • the needle or cannula extends away from the first end portion 2a of the main body 2 to a free end 3a thereof.
  • the needle or cannula 3 extends between a constrained end 3b, fixed to the main body 2 (in particular to the first end 2a), and the free end 3a.
  • the free end 3a is tapered so as to define a tip which facilitates the penetration of the ocular sclera.
  • the device comprises a plurality of surgical instruments 4, 5, 6, 7.
  • the main body 2 has a plurality of seats 11a, 11b, 11c, 11 d for receiving said plurality of surgical instruments 4, 5, 6, 7 therein.
  • this allows the surgeon to have a plurality of interchangeable surgical instruments located inside the single main body 2 and selectively extractable in an alternative manner as a function of the operative needs.
  • Each surgical instrument 4, 5, 6, 7 preferably has an elongated shape and is provided with an active end portion 4a, 5a thereof.
  • the surgical instruments 4, 5, 6, 7 are of the type used for vitreoretinal surgery and can be selected for example from those in the following list:
  • the device 1 comprises at least a first 4 and a second 5 surgical instrument.
  • a third 6 and/or a fourth 7 surgical instrument is also included.
  • the first surgical instrument 4 is defined by a vitrectome and the second surgical instrument 5 by a forceps.
  • a laser defining the third surgical instrument 6 and a back-flush cannula defining the fourth surgical instrument 7 are further shown.
  • all the surgical instruments 4, 5, 6, 7 are reversibly movable between a resting position, in which they are accommodated inside the receiving chamber “C”, and an operating position, in which they are arranged crossing the inner longitudinal cavity of the needle or cannula 3, with said active end portion 4a, 5a protruding from the free end 3a.
  • the second surgical instrument 5 is placed in the resting position.
  • the second surgical instrument 5 is in the operating position, with the active end portion 5a protruding from the free end 3a, the first surgical instrument 4 is placed in the resting position.
  • the third 6 and/or the fourth 7 surgical instrument are also in said resting position.
  • Such third 6 and/or fourth 7 surgical instruments can be placed in the operating position only with the other instruments in the resting position.
  • the device 1 preferably comprises a selecting unit 8 associated with said surgical instruments 4, 5, 6, 7.
  • the selecting unit 8 is accommodated at least partially in the receiving chamber “C” and is configured to alternatively arrange one of the surgical instruments 4, 5, 6, 7 in the operating position upon a command given by a user “S”.
  • the selecting unit 8 is configured to move a surgical instrument 4, 5, 6, 7 to the operating position, keeping the others in the resting position.
  • the selecting unit 8 is preferably configured to arrange one of the surgical instruments 4, 5, 6, 7 in the operating position and the remaining (one or more) surgical instruments in the resting position upon receiving a signal (analog or digital) representative of the selection of said surgical instrument.
  • the selecting unit 8 is associated with the first 4 and second 5 surgical instrument and is configured to arrange the first surgical instrument 4 in the operating position and the second surgical instrument 5 in the resting position, or vice versa, upon a command given by the user “S”.
  • the selecting unit 8 is thus configured to move the first surgical instrument 4 from the resting position to the operating position and the second surgical instrument 5 from the operating position to the resting position upon receiving a first signal representative of a selection of said first surgical instrument 4.
  • the selecting unit 8 is configured to move the second surgical instrument 5 from the resting position to the operating position and the first surgical instrument 4 from the operating position to the resting position upon receiving a second signal representative of a selection of said second surgical instrument.
  • the selecting unit 8 is associated with the first 4, the second 5, the third 6 and/or the fourth 7 surgical instrument and is configured to:
  • first surgical instrument 4 in the operating position and the second 5, third 6 and/or fourth 7 surgical instruments in the resting position, upon receiving a first signal representative of a selection of said first surgical instrument 4;
  • the selecting unit 8 comprises a control element 9 arranged at least partially outside the main body 2 and operable by the user “S” (surgeon himself, assistant, scrub nurse) to generate the signals representative of the surgical instruments 4, 5, 6, 7 selected.
  • the control element 9 can be defined by a mechanical actuator which can be operated manually by the surgeon (e.g., Figure 2) or by an electronic or electromechanical transducer capable of transforming the surgeon’s action into an analog or digital signal.
  • control element 9 is a button configured to generate a related signal representative of the selection of a surgical instrument 4, 5, 6, 7.
  • the selecting unit 8 comprises at least a first actuator 10 partially movable parallel to said longitudinal axis “A” between a retracted position and an extracted position.
  • the first actuator 10 comprises at least one thrust element 10a movable parallel to said longitudinal axis “A” between the retracted position and the extracted position.
  • the thrust element 10a In the retracted position, the thrust element 10a is placed in a distal position from the first end portion 2a of the main body 2 and places the surgical instrument 4, 5, 6, 7 in the resting position, or at least allows the placement thereof in such a position. In the extracted position, the thrust element 10a is instead located near the first end portion 2a of the main body 2.
  • the thrust element 10a is located/configured so as to arrange the surgical instrument 4, 5, 6, 7 associated therewith in the operating position.
  • the first actuator 10 is configured so as to actively act (i.e., in thrust) on a single surgical instrument, without directly acting on the others.
  • the first actuator 10 can comprise a single thrust element 10a, configured to alternatively couple with only one of the surgical instruments (for example with the first 4 or with the second 5 surgical instrument).
  • the thrust element 10a comprises a trigger configured to reversibly couple with each of the surgical instruments 4, 5, 6, 7.
  • the thrust element 10a is configured to couple with an end (or end portion) of the surgical instrument opposite the end portion 4a, 5a.
  • the device could comprise a single thrust (or traction) element 10a arranged coaxially to said needle or cannula 3 and configured to couple with each of the surgical instruments 4, 5, 6 , 7 as a function of a command given by the user “S”.
  • a single thrust (or traction) element 10a arranged coaxially to said needle or cannula 3 and configured to couple with each of the surgical instruments 4, 5, 6 , 7 as a function of a command given by the user “S”.
  • the first actuator 10 comprises a thrust element 10a movable between the retracted position and the extracted position and a gripping unit configured to couple with each instrument previously placed coaxially to the needle or cannula 3.
  • the first actuator 10 comprises a plurality of thrust elements 10a each associated with a respective surgical instrument 4, 5, 6, 7.
  • the first actuator 10 comprises two thrust elements 10a associated with the first 4 and the second 5 surgical instruments, respectively.
  • the first actuator 10 instead comprises four thrust elements 10a associated with the first 4, the second 5, the third 6, and the fourth 7 surgical instruments, respectively.
  • all the thrust elements 10a are movable between the retracted position and the extracted position in a mutually exclusive manner.
  • each thrust element 10a is, in at least one operating position thereof, aligned with a central axis of said needle or cannula 3.
  • each thrust element 10a is movable from the retracted position to the extracted position (and vice versa) only if aligned with the central axis of said needle or cannula 3.
  • the movement of the surgical instrument 4, 5, 6, 7 does not thus stress the structure thereof, to the full advantage of the operating precision and reliability of the device 1.
  • the first actuator 10 is configured to move each surgical instrument 4, 5, 6, 7 from an intermediate position to the operating position, in which the intermediate position is precisely located along a movement path of the surgical instrument 4, 5, 6, 7 between the resting position and the operating position.
  • the selecting unit 8 preferably comprises a second actuator 16, configured to move each surgical instrument 4, 5, 6, 7 from the resting position to the intermediate position.
  • the second actuator 16 of the selecting unit 8 is configured to move all the surgical instruments 4, 5, 6, 7 along a movement path with several stations or steps; at each station or step one of the surgical instruments 4, 5, 6, 7 is placed in the respective intermediate position, aligned with the needle or cannula 3.
  • the selecting unit 8 comprises at least one drum 11 provided with said plurality of receiving seats 11a, 11b, 11c, 11 d.
  • the drum 11 has at least a first receiving seat 11a and a second receiving seat 11b for the first 4 and the second surgical instruments, respectively.
  • the drum 11 also has a third receiving seat 11c and a fourth receiving seat 11 d for the third 6 and the fourth 7 surgical instruments, respectively.
  • the second actuator 16 is configured to move the drum 11 between several positions corresponding to said stations or steps which in number are at least equal to the number of surgical instruments 4, 5, 6, 7; as said, each position is such as to align the respective seat for receiving the surgical instrument with the needle or cannula 3 in order to allow the instrument to be extracted and retracted.
  • the second actuator 16 is configured to receive the signal representative of the surgical instrument 4, 5, 6, 7 selected by the surgeon (generated by the control element 9) and to move the drum 11 upon receiving said signal.
  • each representative signal corresponds to a position of the drum 11 in which the seat for receiving the selected surgical instrument is aligned with the needle or cannula 3.
  • the drum 11 is preferably movable between at least a first position, in which the first receiving seat 11a is aligned with said needle or cannula 3 and at least a second position, in which the second receiving seat 11 b is aligned with the needle or cannula 3.
  • the drum 11 is movable between at least: a first position, in which the first receiving seat 11a is aligned with the needle or cannula 3; a second position, in which the second receiving seat 11 b is aligned with the needle or cannula 3; a third position, in which the third receiving seat 11c is aligned with the needle or cannula 3; a fourth position, in which the second receiving seat 11 d is aligned with the needle or cannula 3.
  • the drum 11 is rotatably accommodated in the main body 2 so as to rotate around said longitudinal axis “A”.
  • the positions of the drum 11 are preferably angular positions. Therefore, in the preferred embodiment the second actuator 16 is of the rotary type.
  • the drum 11 has a central portion 12, coaxial to the longitudinal axis “A”, and a peripheral portion 13, provided with said receiving seats 11a, 11b, 11c, 11d.
  • the drum 11 can be substantially cylindrical, with a markedly distinct central and peripheral portion, or substantially annular, with a very close central and peripheral portion (see figures 3 and 4).
  • the drum can thereby easily rotate in a plurality of angular positions, each corresponding to an operating position in which the thrust element 10a can move from the retracted position to the extracted position and, consequently, the corresponding surgical instrument 4, 5, 6, 7 can move from the resting position to the operating position.
  • the drum 11 is positioned so that the first receiving seat 11a is aligned with the needle or cannula 3 and the related thrust element 10a is arranged in the extracted position, at least partially accommodated inside said first receiving seat 11a.
  • the drum 11 In the operating position of the second surgical instrument 5, the drum 11 is positioned so that the second receiving seat 11b is aligned with the needle or cannula 3 and the related thrust element 10a is arranged in the extracted position, at least partially accommodated inside said second receiving seat 11 b.
  • the drum 11 In the operating position of the third surgical instrument 6 (if present), the drum 11 is positioned so that the third receiving seat 11c is aligned with the needle or cannula 3 and the related thrust element 10a is arranged in the extracted position, at least partially accommodated inside said third receiving seat 11c.
  • the drum 11 In the operating position of the fourth surgical instrument 7 (if present), the drum 11 is positioned so that the fourth receiving seat 11 d is aligned with the needle or cannula 3 and the related thrust element 10a is arranged in the extracted position, at least partially accommodated inside said second fourth seat 11 d.
  • the seats for receiving the non-operating surgical instrument(s) are instead preferably offset with respect to the needle or cannula 3, or misaligned with respect to said needle or cannula 3.
  • the receiving seats of the non-operating surgical instrument(s) are angularly offset with respect to the needle or cannula by an angle equal to the angular offset of each receiving seat with respect to that aligned with the needle or cannula 3.
  • the drum 11 is centrally pivoted to the main body 2 to rotate internally thereto around the rotation axis thereof, preferably corresponding to the longitudinal axis.
  • the receiving seats 11a, 11b, 11c, 11d are angularly equidistant to each other around the rotation axis.
  • the selecting unit 8 comprises an actuation system (not shown) configured to move the drum 11 to the various positions.
  • the second actuator 16 is instead configured to individually move each surgical instrument 4, 5, 6, 7 from the resting position to the intermediate position (and vice versa), without moving the others.
  • the second actuator 16 can be configured to act on a single surgical instrument 4, 5, 6, 7 at a time, bringing the de-selected instrument from the intermediate position to the resting position in succession and the selected one from the resting position to the intermediate one.
  • FIG. 5 An example of such an embodiment is shown in figures 5 and 6, in which the seats 11 a, 11 b, 11 c, 11 d of the surgical instruments 4, 5, 6, 7 are obtained in the main body 2 and are all connected with a single channel 17 (preferably central) aligned with the needle or cannula 3. Such a channel 17 thus corresponds to the intermediate position.
  • the second actuator 16 is configured to withdraw each surgical instrument 4, 5, 6, 7 from the receiving seat 11 a, 11 b, 11 c, 11 d thereof and to position it in said channel 17 (and vice versa); the thrust element 10a is then designed to axially translate the surgical instrument 4, 5, 6, 7 selected into the operating position by moving it from the retracted position to the extracted position.
  • each surgical instrument 4, 5, 6, 7 in the resting position is arranged in the receiving seat, inclined with respect to the longitudinal axis “A” so that the end portion 4a, 5a is proximal to the axis.
  • the actuation system is thus configured to rotate (i.e., tilt) the selected surgical instrument 4, 5, 6, 7 until it is aligned with the channel 17, in an intermediate position.
  • the thrust element 10a is thus configured to couple with the instrument in the intermediate position and bring it, moving towards the extracted position, to the operating position.
  • each surgical instrument 4, 5, 6, 7 preferably comprises an actuation member 14 configured to drive the respective surgical instrument upon receiving a driving signal “DS”.
  • Such an actuation member 14 can be of various nature and location according to the type of surgical instrument; for example, the actuation member 14 can be defined by:
  • a movement system which can be mechanical and integrated in the main body 2 or electromechanical/pneumatic arranged partially remotely with respect to the main body 2 (for example for the arms of a forceps or endovitreal forceps);
  • an electrical resistor system capable of supplying heat (for the diathermocoagulator).
  • the device 1 comprises a driving system 15 operatively associated with the actuation member of each surgical instrument 4, 5, 6, 7 and configured so as to send said (analog or digital) driving signal “DS” to said actuation member 14 upon a command given by the user “S” (i.e., surgeon).
  • a driving system 15 operatively associated with the actuation member of each surgical instrument 4, 5, 6, 7 and configured so as to send said (analog or digital) driving signal “DS” to said actuation member 14 upon a command given by the user “S” (i.e., surgeon).
  • Such a driving system 15 can be of an electromechanical, pneumatic, or purely mechanical nature, and can be located locally at the main body 2, in a remote position or partially in both positions.
  • the driving system 15 preferably comprises at least an interface member 15a configured to detect a command by the user “S” and to generate a representative signal of said command “CS”.
  • the interface member 15a can be of various kinds, either integrated in the main body 2 or separated therefrom.
  • the interface member 15a is associated with the main body 2 and directly determines the actuation of the respective driving member 14.
  • the driving member 14 comprises a tubular member 18 containing the tool (forceps) and slidingly associated therewith so as to activate it (e.g., when opening or closing) following a relative axial movement between the tubular member and the tool.
  • the interface member 15a is preferably defined by at least one pair of arms 19 (preferably two pairs) which can be connected to the related surgical instrument at least when it is in the intermediate position.
  • the two arms 19 comprise a fixed hinge 22 and a movable joint 23 such that, following the application of a transversal/orthogonal pressure to the longitudinal axis “A”, the angle between the arms 19 increases, translating a ring 20 fitted on the tubular member 18.
  • the tubular member 18 is in turn provided with an abutment shoulder 21 which, following a pressure from the ring 20, causes a corresponding translation of the tubular member 18 itself and a consequent movement of the tool.
  • the interface member 15a could be a pedal board provided with a plurality of pedals each configured to generate a special command signal “CS” (see figure 1 in this regard).
  • the driving system 15 further comprises a control unit 15b configured to receive said representative signal “CS” and to generate said driving signal “DS”.
  • the driving system 15 could be hybrid, in part controlled by a remote interface member 15a (e.g., pedal board) and in part by an interface member 15a located on the main body 2.
  • a remote interface member 15a e.g., pedal board
  • control element 9 could be integrated in the main body 2 or in the interface member 15a, or still in a further component of the device 1 , falling in all cases within the spirit of the present invention.
  • the invention achieves the intended purposes and achieves important advantages.
  • the provision of a device which integrates a plurality of interchangeable surgical instruments without removing the needle from the eye greatly facilitates the instrument change operations during surgery, reducing the time of the operation and significantly reducing the fatigue of the surgeon.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Eye Examination Apparatus (AREA)
  • Prostheses (AREA)

Abstract

Un dispositif de chirurgie vitréo-rétinienne comprend un corps principal (2) définissant une chambre de réception (C) à l'intérieur de celui-ci et une aiguille ou une canule (3) pourvue d'une cavité longitudinale interne en connexion avec ladite chambre de réception (C). Le dispositif (1) comprend une pluralité d'instruments, dont au moins un premier instrument chirurgical (4) de forme allongée, et un second instrument chirurgical (5) de forme allongée, et une unité de sélection (8) associée aux premier (4) et second (5) instruments chirurgicaux, logée au moins partiellement dans ladite chambre de réception (C) et configurée pour agencer le premier instrument chirurgical (4) dans la position de fonctionnement et le second instrument chirurgical (5) dans la position de repos, ou vice versa, sur une commande donnée par un utilisateur (S).
EP21725591.8A 2020-04-27 2021-04-22 Dispositif de chirurgie vitréo-rétinienne Pending EP4142667A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT102020000009049A IT202000009049A1 (it) 2020-04-27 2020-04-27 Dispositivo per chirurugia vitreo-retinica
PCT/IB2021/053317 WO2021220109A1 (fr) 2020-04-27 2021-04-22 Dispositif de chirurgie vitréo-rétinienne

Publications (1)

Publication Number Publication Date
EP4142667A1 true EP4142667A1 (fr) 2023-03-08

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EP21725591.8A Pending EP4142667A1 (fr) 2020-04-27 2021-04-22 Dispositif de chirurgie vitréo-rétinienne

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Country Link
US (1) US20230165712A1 (fr)
EP (1) EP4142667A1 (fr)
IT (1) IT202000009049A1 (fr)
WO (1) WO2021220109A1 (fr)

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023105346A1 (fr) * 2021-12-07 2023-06-15 Alcon Inc. Dispositif chirurgical à plusieurs instruments

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5275607A (en) * 1991-09-23 1994-01-04 Visionary Medical, Inc. Intraocular surgical scissors
US9999542B2 (en) * 2014-07-16 2018-06-19 Doheny Eye Institute Systems, methods, and devices for cannula insertion
US11413188B2 (en) * 2016-10-26 2022-08-16 Carl Zeiss Meditec Cataract Technology Inc. Devices and methods for cutting a lens in an eye

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WO2021220109A1 (fr) 2021-11-04
IT202000009049A1 (it) 2021-10-27
US20230165712A1 (en) 2023-06-01

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